Summer is here – and with it an enormous health risk. Dizziness, exhaustion or confusion are just some of the effects of extreme heat, which for some even becomes a deadly danger: According to the Robert Koch Institute, there were around 3,200 heat-related deaths in Germany in 2023 alone.
In view of these figures, Federal Health Minister Karl Lauterbach (SPD) has long seen an urgent need for action. To this end, he presented the “Heat Protection Plan for Health” in July 2023a strategy paper on better heat protection.
The Ministry of Health itself has expanded its information offerings on heat, for example with a poster campaign. The German Weather Service (DWD), a federal authority, is also supposed to use a heat warning system to warn people about heat stress at an early stage. However, the implementation of the heat protection plan is essentially in the hands of the federal government, states, municipalities and the health service.
A heterogeneous picture is emerging in the municipalities. The city of Cologne, for example, published a “Heat Action Plan for Older People” in 2022. It includes an analysis of heat stress and a catalogue of measures to reduce it. “Our simulations show that by 2050, around 43 percent of Cologne’s population could be affected by long periods of heat,” says William Wolfgramm, Cologne’s councilor for climate, environment, green spaces and real estate.
At the beginning of this year, Cologne set up a “climate change adaptation management”: 13 drinking fountains were installed and funding programs for greening were announced. These initiatives are important, but they do not achieve sufficient heat prevention. And not all municipalities or districts are even dealing with the issue. The research network Corrective recently pointed out that several municipalities have not yet implemented any heat protection measures at all.
“In hospital emergency planning, extreme heat counts as a disaster.”
Family doctors also see implementation problems. The BMG’s heat protection plan requires them to sensitize their patients to the dangers of heat. However, such advice must also be included in the remuneration system for family doctors, in studies and in further training, demands Nicola Buhlinger-Göpfarth, Federal Chair of the Association of Family Doctors. “We are feeling the direct effects of climate change more and more and must adapt our work accordingly,” she says. Unfortunately, politicians are lagging behind in terms of investments, “which means we cannot bill for many advisory services and cannot tackle many structural renovations in practices for the purpose of heat protection.”
The challenges are just as immense for hospitals and care facilities. The BMG has developed recommendations to make these facilities more heat-resilient. From the creation of facility-specific concepts to the planning of cooling zones and the proper storage of medicines – The hospital staff therefore has to think about a lot.
At the University Hospital Düsseldorf, Rainer Kram is head of the disaster control department and is responsible for implementing the recommendations. “In hospital alarm planning, extreme heat is considered a disaster,” says Kram. If high temperatures prevail for several days, this leads to problems, “because more vulnerable patients are admitted and the staff themselves are restricted at the same time. We have to take precautions in all areas.” The department has drawn up a heat protection plan tailored to the University Hospital. During heat warnings from the DWD, doctors and nursing staff must then inform patients and relatives about heat protection behavior or move vulnerable patients to cool rooms.
But it is not always the case that a hospital has created a dedicated department to address the heat problem and draw up a heat protection plan. “One third of hospitals have already implemented heat protection plans, one third are devoting themselves intensively to the issue, and the last third are still at the very beginning of implementation,” says Henriette Neumeyer from the board of the German Hospital Association. Central support from management is important for the success of heat protection, she says.
Jana Luntz, member of the executive board of the German Nursing Council and nursing director of the Dresden University Hospital, goes a step further. She demands that hospitals and nursing facilities be legally obliged to develop heat protection concepts: “What happens in hospitals is civil protection. And this cannot just be left to the institutions themselves; it must be legally incorporated into regulations.” However, the heat protection plan does not contain any binding specifications, only recommendations.
Neumeyer and Luntz agree that hospitals need more financial resources for structural changes. “Around 75 percent of hospital buildings in Germany do not meet modern heat protection standards,” says Henriette Neumeyer. She criticizes the fact that hospitals have to pay up front for heat protection measures and hope that these costs will be refinanced later. “This is not a virtuous circle,” she says. “Heat protection coincides with climate protection, and as part of the hospital reform, we need an investment program for climate-resilient hospitals.”
A transformation fund is needed for construction investments as well as for increased operating costs in the course of climate protection. This would then also make it possible to better address the issue of heat protection. The costs for this would, however, be immense. In North Rhine-Westphalia alone, the investment requirement for climate-resilient hospitals will be estimated at 7.1 billion eurosExtrapolated to the Federal Republic of Germany, this means a mid-double-digit billion amount.